Why More Women Than Men Are Dying in the Ebola Outbreak

As news continues to pour in about the devastating outbreak of Ebola in West Africa, it is being reported that more women than men are succumbing to the deadly virus.

The Liberian government, for example, has announced that 75 percent of the country’s Ebola deaths have been of women. And the Washington Post reported last week that when you include Guinea and Sierra Leone along with Liberia, women make up 55 to 60 percent of the deceased.

The biggest driving force behind the gender difference in the death rate comes from cultural aspects of affected communities, according to Pritish K. Tosh, M.D., an infectious disease specialist with the Mayo Clinic in Rochester, Minnesota.

In West Africa, for instance, “women tend to be the primary caregivers when other family members are ill,” he noted. “These women are more likely to be exposed to vomit or feces of an infected family member, which may explain why we are seeing more women with the infection,” he said, nothing that transmission within the community is related to direct contact with blood and other bodily fluids of people who are acutely ill.

Tosh also emphasized that there is not a biological difference at play, meaning women are not at more risk compared with men, given a specific exposure.

The disproportionate Ebola death rates between men and women shouldn’t come as a surprise in light of past research. “Differences in exposure between males and females have been shown to be important factors in transmission of [Ebola],” according to a 2007 World Health Organization (WHO) document. “Therefore, it is important to understand the gender roles and responsibilities that affect exposure in the local area.”

In Liberia, for example, “If a man is sick, the woman can easily bathe him, but the man cannot do so,” Marpue Spear, executive director of the Women’s NGO Secretariat of Liberia, told Foreign Policy this week. “Traditionally, women will take care of the men as compared to them taking care of the women.”

Another 2007 WHO report, “Gender, Health and Malaria,” highlights the fact that gender differences may be seen in other infectious diseases, not just Ebola. As for how to approach a solution, the document, which focuses on malaria, suggests that “education sessions should be developed alongside treatment, with messages targeted at different groups including mothers, pregnant women, men, fathers, male and female adolescents, and schoolchildren. These sessions could focus not only on early recognition of malaria, but also encourage prevention, more equitable household decision-making and the sharing of care-giving activities.”

In general, infectious disease outbreaks are thwarted by tried-and-true public health practices such as identifying the sick and isolating them so that other people are not infected, explained Tosh. “In general this comes down to basic education of people so they can reduce any activities that put them at risk of getting infected — and this tends to hold true for many outbreaks that affect human populations.”